The purpose of this proposal is to longitudinally compare outcomes of surgical treatments for paralytic dysphonia. Vocal performance of patients who suffer from unilateral vocal fold paralysis will be assessed before and after surgical correction of the glottal gap by procedures which either: a) augment, b) medialize, or c) reinnervate the paralyzed vocal fold. Characteristics of vocal performance will be longitudinally assessed: a) acoustically, b) aerodynamically, and c) kinematically. Parameters of acoustic performance are to include measures of fundamental frequency, intensity, pitch range, periodicity/noise. Rate of glottal air flow will be measured as well as vibratory characteristics of the vocal folds by videostroboscopy. A comparison of treatment efficacy is intended to identify or clarify existing a) indications, b) contraindications, c) timing of surgical intervention, and d) long term effects. The results of this study will provide a basis for much needed refinement of medical and surgical strategies in the treatment of glottal incompetence due to paralysis.